Mystery of Healthcare Fraud Detection


Healthcare fraud is difficult to detect and is generally go unnoticed; therefore, detection of such fraudulent claims is necessary, as they increase the burden on society. The use of fraud detection solution enables healthcare firms in accounting, and auditing by predictive data methodologies. Careful account auditing can reveal suspicious providers and policyholders and detect potential fraudulent cases before it occurs.

Large number of fraudulent activities in healthcare, rising number of patients opting health insurance, prepayment review model, increasing pressure of fraud and abuse on healthcare spending is expected to drive the growth of the market. Moreover, increasing adoption of cloud-based analytics, emergence of social media and its impact on the healthcare industry, artificial intelligence (AI) in healthcare fraud detection is expected to provide opportunity for the growth of healthcare fraud detection market during the forecast period

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This Study focuses on global major leading industry players:

1. Verscend Technologies, Inc
2. Fair Isaac Corporation
3. SAS Institute Inc
4. SCIOInspire, Corp
5. Wipro Limited
6. IBM
7. Conduent, Inc
8. HCL Technologies Limited
9. CGI Group Inc
10. McKesson Corporation

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